We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Response to immunosuppressive therapy in PLA<sub>2</sub>R- associated and non-PLA<sub>2</sub>R- associated idiopathic membranous nephropathy: a retrospective, multicenter cohort study.
- Authors
Jia Wang; Qionghong Xie; Zhuxing Sun; Ningxin Xu; Yan Li; Liang Wang; Shaojun Liu; Jun Xue; Chuan-Ming Hao; Wang, Jia; Xie, Qionghong; Sun, Zhuxing; Xu, Ningxin; Li, Yan; Wang, Liang; Liu, Shaojun; Xue, Jun; Hao, Chuan-Ming
- Abstract
<bold>Background: </bold>According to renal M type phospholipase A2 receptor (PLA2R) immunohistochemistry, idiopathic membranous nephropathy (IMN) could be categorized into PLA2R-associated and non-PLA2R-associated IMN. We conducted a retrospective, multicenter cohort study with 91 patients to compare the effect of immunosuppressive therapy between PLA2R-associated and non-PLA2R-associated IMN patients.<bold>Methods: </bold>A total of 91 biopsy-proven IMN patients from Huashan hospital and People's Hospital of Wuxi in past 5 years were collected into this study. IMN with positive PLA2R immunohistochemistry in kidney biopsies were designated as PLA2R-associated IMN. Seventy-eight of the 91 IMN patients was PLA2R-associated IMN and 13 were non-PLA2R-associated IMN. Forty-five patients were treated with prednisone plus cyclophosphamide (CTX), and 46 with prednisone plus calcineurin inhibitors (CNIs). The follow-up duration was 15 months.<bold>Results: </bold>The total remission rate (76.9% versus 44.9%, p = 0.032) and complete remission rate (30.8% versus 2.6%, p = 0.003) were both significantly higher in the non-PLA2R-associated group than in the PLA2R-associated group at the 3rd month visit point, and at the 6th month time point, the complete remission rate was still significantly higher in the non-PLA2R-associated group (46.2% versus 11.5%,p = 0.007). But similar remission rates were found after the 9th month. Relapses were observed in 8 patients in PLA2R-associated group and none in non-PLA2R-associated group, although there was no significant difference between these two groups.<bold>Conclusion: </bold>Compared with the PLA2R-associated IMN, the non-PLA2R-associated IMN responded quicker to the immunosuppressive therapy.
- Subjects
IMMUNOSUPPRESSIVE agents; PHOSPHOLIPASE A2; CALCINEURIN; CYCLOPHOSPHAMIDE; KIDNEY diseases; CELL receptors; COMPARATIVE studies; GLOMERULONEPHRITIS; KIDNEYS; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; EVALUATION research; TREATMENT effectiveness; RETROSPECTIVE studies; PHARMACODYNAMICS; DIAGNOSIS
- Publication
BMC Nephrology, 2017, Vol 18, p1
- ISSN
1471-2369
- Publication type
journal article
- DOI
10.1186/s12882-017-0636-0